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Policy Number Policy Period <br />From To <br />Coverage is Provided in the Agency Code <br />Named Insured and Address Agent <br />Policy Period: Beginning and Ending at 12:01 a.m. Standard Time at the Location of the Described Premises. <br />Business Type: <br />Mortgagee/Loss Payable: <br />Business of the Named Insured: <br />In consideration of the premium, insurance is provided the Named Insured with respect to those premises described in the <br />Schedule below and with respect to those coverages and kinds of property for which a specific Limit of Insurance is shown, <br />subject to all of the terms of this policy including forms and endorsements made a part hereof: <br />LOCATION SCHEDULE <br />DescribedPremises: <br />SECTION I - PROPERTY LIMITS OF INSURANCE <br />Loc No Bldg No Loc No Bldg No Loc No Bldg No <br />Deductible Amount $$$ <br />Building Amount <br />Valuation <br />Business Personal <br />Property Valuation <br />Business Income <br />Business Income <br />Waiting Period <br />Excluded / None / 24 hours / 48hours /72 hours <br />SECTION II - LIABILITY <br />Liability and Medical Expenses Limit $Per Occurrence $Aggregate <br />Medical Expenses $Each Person <br />Damage to Premises Rented to You $ <br />Date Issued:Payment Type: <br />LIMITS OF INSURANCE <br />All Perils <br />391-1002 08 16 Page 1 of 2 <br />4. <br />Liability and Medical Expenses Limits of Insurance: <br />Except for Damage to Premises Rented to You, each paid claim for the following coverages reduce the Amount of Insurance we <br />provide during the applicable annual period. Please refer to SECTION II - LIABILITY, D. LIABILITY AND MEDICAL EXPENSES <br />LIMITS OF INSURANCE, paragraph. of the Businessowners Coverage Form. <br /> BUSINESSOWNERS DECLARATION <br /> BUSINESSOWNERS AMENDED DECLARATIONS EFFECTIVE 08/27/2024 NUMBER 01 <br />33 <br />SUPERSEDES ANY PREVIOUS DECLARATIONS BEARING THE SAME NO. FOR THIS POLICY PERIOD <br />ADDED LOC 5 <br />OB3-J114022-02 08/27/2024 08/27/2025 CITIZENS INSURANCE COMPANY OF AMERICA 100158600 <br />TRUE NORTH COMPLIANCE SERVICES <br />SERVICES, INC. <br />3939 ATLANTIC AVE STE 224 <br />LONG BEACH, CA 90807 <br />949-242-9240 <br />RSC INSURANCE BROKERAGE <br />INC. <br />2040 MAIN ST STE 450 <br />IRVINE, CA 92614 <br />ASSOCIATION. <br /> <br /> <br /> <br /> <br />OFFICE. <br /> <br />NO. 001 001 3939 ATLANTIC AVE, LONG BEACH, CA 90807 <br />NO. 002 001 990 HIGHLAND DRIVE, SOLANA BEACH, CA 92075 <br />NO. 003 001 1336 N CAROLAN AVE, BURLINGAME, CA 94010 <br />(SEE FORM 391-1013 FOR ADDITIONAL PREMISES.) <br />001 001 002 001 003 001 <br /> 500 500 500 <br />NOT COVERED <br /> <br />NOT COVERED <br /> <br />NOT COVERED <br /> <br /> 118,800 <br />RC <br /> 29,700 <br />RC <br /> 29,700 <br />RC <br />ACTUAL BUSINESS LOSS SUSTAINED NOT EXCEEDING 12 CONSECUTIVE MONTHS <br />48 HOURS <br />2,000,000 4,000,000 <br /> 5,000 <br />1,000,000 <br />06/28/2024 ORIGINAL/INSURED ELECTRONIC EXCHANGE <br />GROUP NAME: ARCHITECTS & ENGINEERS GROUP NUMBER: ZJE <br />$$$ <br />81409551 | 24-25 GL-UMB-WC-PL, 23-24 AL | Sherry Young | 8/14/2024 3:19:21 PM (PDT) | Page 5 of 5